胰十二指肠切除术后胃肠功能恢复临床护理路径的构建与应用

doi:10.16460/j.issn1008-9969.2023.17.067

摘要/Abstract

摘要： 目的构建胰十二指肠切除术后胃肠功能恢复临床护理路径并评价其临床应用效果。方法组成胰十二指肠切除术后胃肠功能恢复临床护理路径小组,创建胰十二指肠切除术后胃肠功能恢复临床护理路径表。对我院肝胆外科2022年2—12月收治的30例胰十二指肠切除术患者,制定胰十二指肠切除术后胃肠功能恢复临床护理路径按照路径实施护理;以2021年1月—2021年12月收治的30例采用胰十二指肠切除术后常规护理的胰十二指肠切除术患者作为历史对照;对比2组患者术后肠鸣音恢复时间、术后首次肛门排气时间、术后首次排便时间、术后胃管留置时间及术后平均住院时间的差异。结果按照临床路径实施胰十二指肠切除术后管理,干预组术后肠鸣音恢复时间（45.0±10.6 vs 58.2±18.7）、术后首次肛门排气时间（48.0±10.9 vs 63.0±18.6）,术后首次排便时间（66.6±14.4 vs 90.0±23.1）、术后胃管留置时间（73.0±33.3 vs 100.5±49.9）、术后平均住院时间（13.5±5.2 vs 16.6±4.5）均短于对照组,差异均具有统计学意义（P<0.05）。结论构建并实施胰十二指肠切除术后患者胃肠功能恢复临床护理路径表,能促进胰十二指肠切除术后胃肠功能恢复并加快患者康复出院。

关键词: 胰十二指肠切除术, 胃肠功能, 临床护理路径

Abstract: Objective To construct a clinical nursing pathway for gastrointestinal function recovery after pancreaticoduodenectomy (PD) and to evaluate its clinical effect. Methods A clinical nursing pathway group was established and a clinical nursing pathway for gastrointestinal function recovery after PD were formed. The clinical data of 30 patients after PD in the hepatobiliary surgery nursing unit from February 2022 to December 2022 were retrospectively analyzed, which were given postoperative care according to the nursing pathway (intervention group). A total of 30 PD patients receiving routine care after pancreaticoduodenectomy from January 2021 to December 2021 were selected as historical controls (control group). The effects of the two nursing methods on the recovery time of bowel sounds, the time of the first postoperative anal exhaust, the time of the first postoperative defecation, the time of postoperative gastric tube indwelling and the average postoperative hospital stay were compared. Results After the implementation of the clinical nursing pathway, postoperative recovery time of bowel sounds (45.0±10.6 vs 58.2±18.7), postoperative first anal exhaust time (48.0±10.9 vs 63.0±18.6), postoperative first defecation time (66.6±14.4 vs 90.0±23.1), postoperative gastric tube indwelling time (73.0±33.3 vs 100.5±49.9) and postoperative average hospital stay (13.5±5.2 vs 16.6±4.5) in intervention group were shorter than those in the control group, and the differences were statistically significant (P<0.05). Conclusion PD nursing pathway can promote postoperative recovery of gastrointestinal function and rehabilitation.

Key words: pancreaticoduodenectomy, gastrointestinal function, clinical nursing pathway

中图分类号:

R473.6

徐永丽, 蔡少如, 毛惠娜, 邱键霞, 梁景花. 胰十二指肠切除术后胃肠功能恢复临床护理路径的构建与应用[J]. 护理学报, 2023, 30(17): 67-72.

XU Yong-li, CAI Shao-ru, MAO Hui-na, QIU Jian-xia, LIANG Jing-hua. Construction and implementation of clinical nursing pathway for gastrointestinal function recovery in patients after pancreaticoduodenectomy[J]. Journal of Nursing, 2023, 30(17): 67-72.

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